Strategies for Preventing Antimicrobial Resistance

A campaign to prevent antimicrobial resistance in healthcare settings was announced by the US Centers for Disease Control and Prevention (Atlanta, USA) at the International Conference on Emerging Infectious Diseases in Atlanta.

The campaign comprises four key strategies. These are to prevent infection, diagnose and treat infection effectively, use antimicrobials wisely, and prevent the transmission of drug-resistant pathogens. Within these strategies are 12 specific action steps derived from evidence-based guidelines and recommendations that clinicians can use to prevent antimicrobial resistance in hospitalized adults.

Action Step 1 is to give influenza/S pneumonia vaccine to at-risk patients before discharge. Step 2 is to use catheters only when essential and remove them when no longer essential. Step 3 is to culture the patient, target empiric therapy to likely pathogens, and target definitive therapy to known pathogens. Step 4 is to consult infectious disease experts for patients with serious infections. Step 5 is to engage in local antimicrobial control. Step 6 is to know your antibiogram.

Step 7 is to treat infection, not contamination. Step 8 is to treat infection, not colonization. Step 9 is to know when to say "no” to vancomycin. Step 10 is to stop antimicrobial treatment when infection is treated or unlikely. Step 11 is to use standard infection control precautions, contain infectious body fluids, and consult infection control experts when in doubt. Step 12 is to break the chain of contagion by staying home when sick, keeping hands clean, and setting an example.

Antimicrobial resistant infections in healthcare settings are a major threat to patient safety. Each year in the United States alone, an estimated 2 million hospitalized patients acquire infections that result in more than 90,000 deaths. More than half are caused by bacteria that are resistant to at least one of the antimicrobials commonly used to treat those infections, says the CDC.

"We are confident that this campaign will help prevent the emergence and spread of antimicrobial resistance in healthcare settings and make healthcare in the United States even safer than it is today,” said Dr. Julie Gerberding, director of the CDC campaign.




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